骨髓增生异常综合征与再生障碍性贫血骨髓细胞形态学表现的比较
Comparison of bone marrow cell morphology between myelodysplastic syndrome and aplastic anemia

目的:分析骨髓增生异常综合征(MDS)与再生障碍性贫血(AA)骨髓细胞形态学表现的差异。方法:回顾性收集首诊确诊为MDS(423例)与AA(383例)病例的资料,比较两者骨髓细胞形态学表现。结果:MDS患者骨髓中早幼粒细胞、中幼粒细胞、晚幼粒细胞、中性杆状核粒细胞、中性分叶核粒细胞、早幼红细胞、中幼红细胞、晚幼红细胞比例均高于AA患者,而淋巴细胞、成熟单核细胞、成熟浆细胞比例低于AA患者(P<0.05)。MDS患者多表现为骨髓细胞三系增生、病态造血或原始细胞比例增高,粒系红系增生伴巨核系增生减低或原始细胞比例增高,而AA患者多表现为三系增生减低或原始细胞比例减低(P<0.05)。MDS比AA更多地表现为病态造血。结论:MDS与AA在骨髓细胞形态学方面存在明显差异。
Aim: To compare bone marrow cell morphology between myelodysplastic syndrome(MDS)and aplastic anemia(AA).Methods: The data of MDS(n=423)and AA(n=383)patients were retrospectively collected, and the morphological indexes of their bone marrow cells were compared.Results: MDS patients had higher levels of promyelocytes, myelocyte, metamyelocyte, neutrophilic granulocyte band form, neutrophilic granulocyte segmented form, basophilic erythroblast, polychromatophilic erythroblast, and normoblast proportion, and lower levels of lymphocytes, mature monocytes proportion, and mature plasma cells proportion(P<0.05).The MDS patients mainly showed triploid hyperplasia and high proportion of morbid hematopoiesis or primitive cells, two-line hyperplasia and low level of megakaryocytic hyperplasia or high primitive cells proportion, while the AA patients mainly showed low level of triploid hyperplasia or low proportion of primitive cells(P<0.001). MDS more commonly manifested as morbid hematopoiesis than AA.Conclusion: The bone marrow cell morphology is different between MDS and AA